在醫(yī)學實踐中,，蔗糖常被醫(yī)生用作嬰兒鎮(zhèn)痛劑，來緩解嬰兒在醫(yī)療過程中產(chǎn)生的疼痛,。但最新發(fā)表在醫(yī)學?？读~刀》上的一篇論文則警告稱，用蔗糖作為嬰兒鎮(zhèn)痛劑是無效的,，長此以往可能導致嬰兒的大腦受損,。
在對嬰兒進行注射、抽血化驗和穿刺時,，給其服用少量的蔗糖以緩解疼痛,，是臨床治療中的一種普遍做法。過去也有研究證實這種做法是有效的,，一些權(quán)威醫(yī)學刊物上也發(fā)表過相關(guān)研究論文,，證實了蔗糖的鎮(zhèn)痛效用。但最近英國一研究小組則認為,，這些研究僅靠嬰兒在接受蔗糖時面部表情的變化來判定蔗糖的鎮(zhèn)痛效果,，遠不足以證實蔗糖具有鎮(zhèn)痛效用。
該研究小組對59名新生兒進行了對照試驗,。他們將新生兒隨機分成兩組,，在對其進行醫(yī)學穿刺前兩分鐘,，分別給他們服用小劑量蔗糖和無菌水,，在穿刺后對嬰兒大腦和脊髓神經(jīng)痛感水平的測量結(jié)果表明，這兩組被試嬰兒的痛感程度并沒有顯著差別,，服用蔗糖的嬰兒的痛感并沒有得到緩解,。嬰兒的肢體肌肉反應(yīng)同樣表明,，蔗糖不具備鎮(zhèn)痛效用。
論文作者之一,、倫敦大學學院的麗貝卡·斯萊特博士表示,，研究結(jié)果表明,蔗糖并不是一種有效的止痛藥物。而越來越多的證據(jù)表明,，疼痛對嬰兒的神經(jīng)發(fā)育會產(chǎn)生負面影響,。因此，在未弄清蔗糖的影響之前,，應(yīng)該停止將其作為嬰兒鎮(zhèn)痛劑來使用,。（生物谷Bioon.com）
生物谷推薦英文摘要：
The Lancet doi:10.1016/S0140-6736(10)61303-7
Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial
Dr Rebeccah Slater PhD a b , Laura Cornelissen MSci b *, Lorenzo Fabrizi PhD b *, Debbie Patten BSc b, Jan Yoxen BSc b, Alan Worley MSc c, Stewart Boyd MD c, Judith Meek MBBS d ?, Prof Maria Fitzgerald PhD b ?
Background
Many infants admitted to hospital undergo repeated invasive procedures. Oral sucrose is frequently given to relieve procedural pain in neonates on the basis of its effect on behavioural and physiological pain scores. We assessed whether sucrose administration reduces pain-specific brain and spinal cord activity after an acute noxious procedure in newborn infants.
Methods
In this double-blind, randomised controlled trial, 59 newborn infants at University College Hospital (London, UK) were randomly assigned to receive 0·5 mL 24% sucrose solution or 0·5 mL sterile water 2 min before undergoing a clinically required heel lance. Randomisation was by a computer-generated randomisation code, and researchers, clinicians, participants, and parents were masked to the identity of the solutions. The primary outcome was pain-specific brain activity evoked by one time-locked heel lance, recorded with electroencephalography and identified by principal component analysis. Secondary measures were baseline behavioural and physiological measures, observational pain scores (PIPP), and spinal nociceptive reflex withdrawal activity. Data were analysed per protocol. This study is registered, number ISRCTN78390996.
Findings
29 infants were assigned to receive sucrose and 30 to sterilised water; 20 and 24 infants, respectively, were included in the analysis of the primary outcome measure. Nociceptive brain activity after the noxious heel lance did not differ significantly between infants who received sucrose and those who received sterile water (sucrose: mean 0·10, 95% CI 0·04—0·16; sterile water: mean 0·08, 0·04—0·12; p=0·46). No significant difference was recorded between the sucrose and sterile water groups in the magnitude or latency of the spinal nociceptive reflex withdrawal recorded from the biceps femoris of the stimulated leg. The PIPP score was significantly lower in infants given sucrose than in those given sterile water (mean 5·8, 95% CI 3·7—7·8 vs 8·5, 7·3—9·8; p=0·02) and significantly more infants had no change in facial expression after sucrose administration (seven of 20 [35%] vs none of 24; p<0·0001).
Interpretation
Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief
